Paul Farmer, Chief Executive, Mind
Jul 17, 2018
Over the years, we have become more and more familiar with messages about how we take care of our physical health – encouragement to think about what we eat, take regular exercise and to be aware of the signs of developing a major health condition. We are only just beginning to start to think in the same way about our mental health. As the stigma surrounding mental health problems begins to recede, we are in a position to be much more receptive to thinking about our mental health and what we can do about it.
But how do we think about the inter-relationship between our mental health and our physical health, especially in the context of supporting people who develop a long-term mental health problem?
This new research by Guy’s and St Thomas’ Charity shines important light on this complex inter-dependency, and reveals some fundamental challenges presented by the way we currently approach multiple long-term conditions. For me, there are three key lessons from the report which require further exploration.
First of all, there is often a failure to recognise the impact on mental health of developing a physical long-term condition, which can be considerable. It may well be a condition that stops you doing the things you enjoy, or that threatens your ability to work. You may have looked it up online and found that your life expectancy has diminished. Depression is one of the most common long-term conditions experienced by people living with more than three conditions, yet people who are diagnosed with a long-term physical condition are rarely asked about their mental health in this context.
There is often a failure to recognise the impact on mental health on developing a physical long-term condition, which can be considerable.
Secondly, the consequences of this lack of join-up are profound. Depression is the most common long-term condition diagnosis in younger people and the research found that the presence of depression can lead to other long-term physical conditions, like morbid obesity. Starting with what we need to better support and manage our mental health is therefore vital to improving outcomes holistically across a range of long-term conditions.
Thirdly, the study highlights the importance of tackling inequalities within a local community, and giving that community a fundamental sense of ownership and voice in how a range of services and support are delivered. People from the most deprived areas develop multiple long-term conditions on average 13 years earlier than those living in the least deprived areas. Without addressing this inequality, longstanding failures to improve mental health and physical health care for people will remain intractable.
Starting with what we need to better support and manage mental health is vital to improving outcomes holistically across a range of long-term conditions.
Fortunately, there are signs of hope. Recent pilots connected to the Improving Access to Psychological Therapies (IAPT) programme showed that increasing access to therapy for people with long-term conditions can have a positive impact on both mental and physical health. The work of networks such as Black Thrive point to the potential for community-led approaches and recent announcements about additional resourcing for the NHS have included firm commitments to prioritising mental health.
This research and the Charity's approach has the potential to bring together how services address physical health and mental health in a way not seen before, but most importantly to improve lives for many people who have gone far too long without the support and help they need and deserve.
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Ahead of the Nuffield Trust Health Policy Summit, our Chief Executive, Kieron Boyle, discusses the five things we've learned about multiple long-term conditions.